About 12 years ago, Ron Zittlau left his hometown of Edmonton for Tofino, lured by the call of the ocean. Nearly every day, he gets up at the crack of dawn, straps his surfboard to the side of his bike, rides a couple of hundred metres to the beach, then hops on his board and paddles out to sea. He surfs for hours. Sometimes in the summertime, he goes twice or even three times a day. When he catches a wave, he’s sitting on top of the world.

“I came out here on holidays and tried surfing and just fell in love with it,” Zittlau says on the line from Pacific Rim National Park. “I sold everything and moved out here.”

Zittlau, a welder who runs a vacation-rental company with a friend, is his own boss, able to build his work schedule around the tides. Spending countless hours in the ocean has numerous health benefits. Besides being excellent cardiovascular exercise that helps build strength and endurance, it does wonders for the soul. But Zittlau has learned the hard way that surfing can have a serious side effect. He has a severe case of surfer’s ear, or exostosis, a bony growth in the ear canal that results from long-term exposure to cold water or air.

“You know what it’s like when you have water in your ear?” Zittlau asks. “That’s what it feels like, but it never goes away. Your head’s all plugged up and you get ringing in your ears. Last summer it was so bad I was almost losing my mind. It was driving me nuts.”

Things went from bad to worse for Zittlau when he went on a boat trip up north in search of big waves and found them, getting pushed underwater over and over again.

“Both my ears were plugged, and I only had about 10 percent of my hearing,” he says. “I’d see people moving their lips but I couldn’t hear what they were saying.”

Dr. Neil K. Chadha, a doctor in the division of pediatric otolaryngology, head and neck surgery, at B.C. Children’s Hospital, says that exostosis itself doesn’t cause permanent hearing loss. But the bone can grow so much that, over time, it can completely block the ear canal, making hearing difficult unless it’s removed. And it can also lead to infections, because water, wax, or debris can easily get trapped in the ear canal.

“Ear infections are very painful,” Chadha says on the line from his office. “The ear is very sensitive, and it can get quite tender.”

The development of more sophisticated wet and dry suits has enabled ocean lovers to recreate in ever colder waters, which, according to the California Ear Institute, has likely increased the prevalence and severity of exostosis.

The rate of the condition is 600 percent higher in cold-water surfers than in those who prefer more tropical climes. The colder the water, the faster the bony growth progresses.

People tend to be diagnosed with the condition in their 30s or 40s, Chadha adds, because of the slow progression of bone growth from years of cold-weather exposure.

“It’s a sort of reaction or irritation to chronic cold,” Chadha says. “The bone closes up and starts to grow inwards.”

Once formed, the bone growth is irreversible.

In extreme cases, when the bone constricts the ear canal or blocks it completely, leading to hearing loss, surgery is required. A surgical drill is used to remove the growth.

Surfer’s ear can easily be prevented, and the sooner people start using protective measures the better, Chadha says. People of all ages, including those in their 20s and teens, who practise any cold-water sport, such as sailing, kayaking, diving, windsurfing, and ocean swimming, should be aware of simple strategies like earplugs.

Custom earplugs that are created by making an impression of the ear canal are especially effective.

Surfers like Zittlau should also wear a neoprene hoodie or cap to keep water out of their ears, regardless of the weather or water temperature.

Using ear drops after being in the water can help too. Among the over-the-counter products are the made-in-Australia Sassall Surfer’s Ear drops. (Zittlau, who’s “fighting tooth and nail” against having surgery, swears by them.) Chadha says drops made of equal amounts of vinegar and water are another option, as is using a warm-air ear dryer.

Surfer’s ear is not to be confused with swimmer’s ear, Chadha notes. Clinically known as otitis externa, the latter is an inflammation and infection of the outer ear and ear canal. It develops when water, sand, dirt, or other substances get in the ear and when the protective film inside is scratched or worn away.

Chlorinated pools tend to be safer than lakes or oceans.

The best way to keep the ears infection-free, Chadha says, is to follow a simple golden rule of otolaryngology.

“We have a saying”¦that nothing smaller than your elbow should ever be inserted inside your ear,” he says. That includes cotton swabs and fingernails. “The ears are designed to clean themselves.”